2. Basic Suturing Techniques
AANSA Inaugural Conference and AGM
Sat

3. Holding the needle
Hold the needle 1/3 to 2/3 ratio in needle holder

4. Placing the suture
Wrist extension ensures 90 degree placement of suture

6. Placing the suture cont.
Perpendicular exit through skin on second side
Pull needle through in curve of needle

7. Ensure wound eversion

8. Eversion cont.

10. Tying the knot

11. The first throw

12. Sliding the first knot

14. Adjustment of the knot

17. Limitations of superficial sutures

18. Buried absorbable suture with buried knot

19. Buried subdermal

20. Buried subdermal cont.

21. Buried suture and epidermal suture

25. Vertical Mattress Suture

27. Vertical Mattress Suture
Used if skin eversion is required and not possible with simple sutures
Leaves obvious cross hatching
Remove early

29. Horizontal Mattress Suture
Good eversion
Useful in thick glaborous skin (feet and hand)
More ischaemia of wound edges

30. Subcuticular Suture Interrupted or running Superficial Dermis
Place all sutures at same level
No Suture marks
Absorbable or non absorbable

32. Half buried Horizontal Mattress Suture
Less Strangulation of flap edges
Leave Knots on one side of wound only (eg. On areola for nipple suturing)

34. Other Closure Techniques
Over and Over suture
Quick
Haemostatic
Useful on scalp
Beware ischaemia

36. Other Closure Techniques
Skin staples
Quick
Temporary use to approximate skin
Use forceps to evert edges and prevent inversion
Remove early to prevent skin marks

37. Other Closure Techniques
Skin tapes
Approximate wound edges
Use dermal sutures to take tension & prevent wound inversion

38. Questions

39. THANK YOU